Use of BMP in practice for craniomaxillofacial surgery: clinical experiences

Oral Presentation Patients and methods: Forty eight implants were installed in 22 patients. Implants were divided into three groups. In the first group (I) conventional full flap technique was used to gain access to the implant site. While in the second group (II) miniincision technique was used. Punch technique was used in the third group (III). The patients were recalled immediate, 6 and 12 months postoperatively for clinical evaluation. The crestal bone height was evaluated using Cone Beam CT immediate and at 12 months postoperatively to detect the amount of bone loss. The data was analyzed statistically to compare the results of all groups throughout the study intervals. Data were presented as means and standard deviation (SD) values. Annova test was used to compare between the groups and p value was set equal or less than 0.05 for the results to be statistically significant Results: The data was analyzed statistically to compare the results of all groups throughout the study intervals. Data were presented as means and standard deviation (SD) values. Annova test was used to compare between the groups and p value was set equal or less than 0.05 for the results to be statistically significant The results revealed that the mean of crestal bone loss was 1.11 mm for the conventional flap group while it was 0.3 mm in the mini incision technique group and 0.36 mm for the flapless punch technique group at the end of follow up period. Accordingly, there was no statistical significance between crestal bone loss in the later two groups throughout the follow up period. Meanwhile, the mean of keratinized mucosa around dental implant were 2.6 ± 0.7 mm for group I, 2.4 ± 0.9 mm for group II and 1.9 ± 0.4 for group III. However, the average amount of soft tissue recession for the conventional flap group (I) was 1.27 ± 0.19 mm, for group II was 1.54 ± 0.22 mm while it was 0.6 ± 0.03 mm for the flapless punch technique group. Comparing Implant mobility and bleeding index revealed no statistically significant difference between all groups at the end of follow up period, while the mean probing depth was slightly higher in the first two groups. Conclusion: It was concluded that flapless implant surgery reduces the amount of crestal bone loss, reduces edema, pain and discomfort at the surgical site in comparison to the conventional flap technique. Mini incision technique might preserve the keratinized mucosa. So it is recommended to be the technique of choice in patients with deficient keratinized mucosa http://dx.doi.org/10.1016/j.ijom.2015.08.787 Use of BMP in practice for craniomaxillofacial surgery: clinical experiences E. Stelnicki 1,2 , J. Portnof 1,2 , M. Daya 1,2 , R. Semensohn 1,∗ 1 2

Nova Southeastern University, Fort Lauderdale, United States Joe Dimaggio Children’s Hospital, Hollywood, United States

Background: The clinical use of bone morphogenic protein and its derivatives (rhBMP-2) has documented effectiveness in increasing bone growth in areas of deficiency. Some literature has shown that the use of BMP appears to promote cancer at higher rates versus the general population as a whole (Drazin et al., 2014). Craniomaxillofacial defects, whether traumatic, infectious, neoplastic, or congenital presents an issue with regards to reconstruction. The gold standard of reconstruction is currently autologous grafting. However this procedure, with secondary surgery presents with potential complications such as delayed healing time, increased morbidity, incomplete healing at the donor site, and graft rejection (Herford et al., 2011).

e139

Objectives: The authors of this paper intend to describe the experiences with BMP, and illustrate the safety and efficacy used in craniomaxillofacial surgery. Methods: Numerous pediatric patients with craniomaxillofacial defects, including cleft lips and palates, where repaired using BMP. Follow-up appointments were scheduled over a number of years at regular intervals to asses the growth of bone in the defective area, as well as appreciation for post operative complications including, feeding issues, fistulas, bone spurs, chronic pain, infections, and any soft tissue growth or tumors. Of these patients thirteen received multiple Computed Tomography (CT) scans, both preoperative and postoperative, to monitor the progression of the intervention. Findings and conclusions: Of note zero tumors or growths were appreciated on any of the patients. There was also no significant number of other complications. http://dx.doi.org/10.1016/j.ijom.2015.08.788 The effect of endotracheal intubation to temporomandibular joint functions G. Senol Guven 1,∗ , S. Tufekcioglu 1 , E.A. Kose 2 , S. Uckan 1 1 University of Medipol, Department of Oral & Maxillofacial Surgery, Istanbul, Turkey 2 University of Medipol, Department of Anestesiology & Reanimation, Istanbul, Turkey

Background: Temporomandibular joint (TMJ) dysfunction is a common situation after endotracheal intubation for general anesthesia. During endotracheal intubation with laryngoscope to provide a good view of the epiglottis and vocal cords excessive forces may applied to TMJ apparatus. Objectives: The purpose of this study is to evaluate the effects of endotracheal intubation to TMJ functions pre and postoperatively. Methods: 250 patients who were to undergo endotracheal intubation for general anesthesia at the Hospital of Medipol University were included in the study. Patients who refer to general surgery, orthopedics and urology departments were examined with a form at preoperative routine evaluation and 1 day postoperatively. The form contains the presence and localization of facial and preauricular pain, amount of maximum mouth opening, trace of mouth opening, clicking or crepitus during function, the presence of trigger points or any other TMJ symptoms. Findings: Preop and postoperative incidence of TMD symptoms were evaluated. The Mallampati score was associated with interincisal distance. Male and female subjects for Mallampati scores or duration of intubation were also evaluated. Conclusions: It is important to assess the patient preoperatively for prior TMJ symptoms by anesthesiologists, and managed accordingly endotracheal intubation procedure. http://dx.doi.org/10.1016/j.ijom.2015.08.789